Foot Pain Identifier

Our feet sustain our body weight and keep us moving throughout the day. No wonder why each of them is made of 26 bones, 33 joints, and over 100 muscles, tendons, and ligaments. However, most of us do not take care of our feet until they start hurting. According to American Podiatric Medical Association (APMA), nearly 8 out of 10 Americans have experienced foot pain at least once in their life, which means most of us are prone to foot problems.

Foot pain can be caused due to orthopedic trauma, diseases, and injuries. Poor biomechanical alignment of your feet, ankle, and knees and ill-fitting footwear are also responsible for pain and discomfort. Foot problems can make it difficult for you to continue doing your basic work such as walking, exercising, and even standing, thereby severely affecting the quality of your life. Thankfully, most foot problems do not require any extensive treatment such as a surgery. All they require is correct diagnosis and timely treatment. In this article, we have listed some common foot problems and their symptoms.

Please note that this article is for educational purpose only and must not be considered as a diagnostic tool or a substitute for a doctor’s advice and treatment. You must consult your primary care physician or podiatrist for correct diagnosis and treatment.  

 

Pain on Top of Foot

Strenuous activities such as running, jumping, and kicking are some of the common reasons for pain on top of foot. If you have taken up a new activity or have suddenly started doing a strenuous activity, you are more likely to suffer from the foot problems. Some such foot problems are stress fractures, Extensor Tendonitis, Tibialis Anterior Tendonitis, gout, Athlete’s foot, Tarsal Coalition, flat feet, and degenerative arthritis. If you are suffering from pain on top of foot, give your legs some rest. Discontinue all your strenuous activities, and apply ice to the painful area of your foot. Consult a podiatrist or a general physician if the pain persists for more than a week. Let us now look at some common foot problems that cause pain on top of foot:

 

Stress Fractures

It is one of the common sports injuries, caused due to overuse of the foot muscles. When the muscles become fatigued, they are no longer able to absorb the excess shock and, eventually, they pass on the shock to the bones, causing tiny cracks. These tiny cracks are called stress fractures. In most cases, the cracks occur in the weight-bearing bones of the foot i.e. the metatarsal bones.

Stress fractures may happen when you have suddenly increased the amount or intensity of your activity. Improper footwear is also responsible for causing muscle fatigue and cracks. The most common symptoms are pain, tenderness, and swelling in the metatarsal bone. The pain is severe during the activity. Stress fractures are usually determined using X-rays, CT scan, and MRI. Adequate rest and discontinuation from all forms of strenuous activities for 6-8 weeks are recommended for treating these tiny cracks.

 

Extensor Tendonitis

Extensor tendons of legs (they are also present in hands) are the tendons that attach your front leg muscles with that of your toes. These tendons sit right beneath the skin and therefore, they have very little padding to protect them from injuries. Extensor tendonitis is a condition in which these tendons become inflamed. The inflammation is usually caused due to wearing tight footwear. People who remain on their feet for long durations are also vulnerable to extensor tendonitis. Pain on top of foot, specifically around the midpoint is the main symptom. The pain builds up gradually and gets worse when you keep continuing your physical activity. Adequate rest, physical therapy, stretching and strengthening exercises are usually recommended for extensor tendonitis.

 

Tibialis Anterior Tendonitis

The anterior tibialis tendon is located at the front part of your ankle and it connects the anterior tibialis muscle to the rest of the foot muscles. The main function of this tendon is to flex the foot upwards i.e. towards the head. When it is overused, it can become irritated and inflamed, thereby causing tibialis anterior tendonitis, which is also known as tendinopathy. The inflammation is usually caused due to excessive stress caused by repetitive movements of legs such as playing tennis, running, and kicking sports. Walking or standing on hard surfaces such as concrete for hours, hill running, and walking on uneven surfaces can also cause tibialis anterior tendonitis. Further, if you are into a sport that requires you to tie an equipment or a shoelace too tightly around your ankle, you are more prone to getting this condition. Pain on the inner front of the ankle and the midfoot, palpation, swelling on the inner side of the ankle, and feeling of ankle weakness are some of the signs of tibialis anterior tendonitis. Rest, icing, bracing, and physical therapy are some of the conservative treatment for this painful foot condition.

 

Gout

Gout is a type of inflammatory arthritis caused by the accumulation of urate crystals in your joints. These crystals can accumulate in foot, ankle, elbow, wrist, and almost any joint of the body but the big toe is the most common place for gout to occur. Urate crystals start accumulating when you have a high level of uric acid in your body, which could be due to two reasons; either your body is producing too much uric acid or your kidneys are unable to excrete uric acid properly. When the crystals start building up, they can cause sudden severe pain and swelling, redness and tenderness at the joint. You will also feel as if your big toe is on fire. Dietary and lifestyle changes are usually advisable for people suffering from gout pain.

 

Athlete’s Foot

Also known as tinea pedis, athlete’s foot is a fungal infection that affects the skin of the feet, especially the area between the toes. It is a contagious disease that often spreads through physical contact such as walking barefoot in the swimming area, locker room, communal showers, nail salons, gyms, and any other area where an infected person may have been recently present. You may also get this infection if you wear tight-fitted shoes with improper ventilation, a perfect atmosphere for the fungus to grow. Despite its misguiding name, both athletes and non-athletes are at equal risk of suffering from athlete’s foot. Common signs of athlete’s foot are itchy white patches between your toes, itching and burning sensation on the soles of the feet, blisters on the feet, flaky patches between the toes, skin crack and slight bleeding between the toes, and dryness and scaling of the sole. OTC antifungal medicines are usually recommended for this condition.

 

Tarsal Coalition

It is an abnormal fusion of two or more tarsal bones i.e. the bones located at the back of the foot and the heels. The fusion of the bones can result in a severe case of flatfootedness, thereby affecting your everyday physical activities. In most cases, the tarsal coalition is present at birth. However, in some rare cases, it may be caused due to arthritis or injury. Although it sounds strange, tarsal condition is a fairly common foot problem, affecting one out of every 100 people. It develops right at the fetal stage but most children do not show any kind of disorder until they grow up. This is because children’s feet have a thick layer of growing cartilage. In most cases, people do not experience any symptoms of tarsal coalition. However, some people may experience stiff, painful feet and a rigid flat foot. The pain is usually around below the ankle around the middle of the foot. Rest, orthotics, and medications are often recommended for people who are experiencing the pain associated with tarsal coalition. If conventional treatment fails, surgery may be recommended.

 

 Flat Feet

The middle part of a normal human foot is slightly raised off the ground when you stand. This raised part is known as the arch. It acts as a shock absorber and distributes the weight evenly throughout the foot. However, in some people, the arches are absent i.e. the entire foot touches the ground. In most cases, flat feet aren’t a problem but, in some, the fallen arches can cause pain in arch of foot, heels, ankle, lower legs, knees, hips, and lower back. Some people with flat feet may suffer from overpronation i.e. a condition in which the feet rolls inwards while walking or running. Genetic factors, weak arches due to aging or sedentary lifestyle, foot and ankle injury, arthritis, nervous diseases, and tarsal coalition are some of the reasons why you may suffer from this painful condition. Treatment options include stretching exercises, wearing supportive footwear, and orthotics, taking painkillers, and physiotherapy.

 

Degenerative Arthritis

Degenerative arthritis, also known as osteoarthritis is a chronic disease that damages the cartilages and tissues around the joints. It is the most common form of arthritis, affecting around 31 million Americans. It is primarily caused due to aging, but obesity, congenital deformity, gout, rheumatoid arthritis, diabetes, hormonal disorders, and some other underlying causes may trigger it. When the cartilages are damaged, you could suffer from severe pain, swelling and, even limited mobility. Degenerative arthritis can affect the hands, feet, spine, hip, knees, and some other major joints of the body. If you are suffering from pain on top of foot around the joints, along with stiffness, swelling, and warmness you could probably be suffering from degenerative arthritis. The pain and stiffness are worse after a long period of inactivity. Please consult your doctor for proper pain management and treatment.

 

Foot Arch & Heel Pain

Heel pain is a common foot problem. Very often, it indicates that there is something wrong with your body and that you need to pay attention to your lifestyle. If the heel pain or pain in arch of foot occurs right after an injury or exercise, it is a warning sign that your body requires some rest. Foot pains are usually common in middle-aged women and men or among those people who are regularly involved in high-intensity sports. Obesity is also a major factor behind foot problems. Here are some of the reasons why you may be suffering from foot arch and heel pain.

 

Plantar Fasciitis

If you are suffering from stabbing heel pain which is worst in the morning with the first few steps, you are most probably suffering from plantar fasciitis. The pain normally decreases during the day but may occur after a long period of inactivity. Plantar fasciitis is one of the most common causes of heel pain. It is a condition which involves inflammation of plantar muscles, a thick band of tissues that run across the bottom of your foot and connects the toes with the heel. The inflammation of the plantar muscles could be caused due to a sudden increase in high-intensity activities, aging, obesity, and standing or walking for long hours on hard surfaces. Home remedies include rest, stretching exercises, wearing supportive footwear, and using orthotic insoles for supporting the damaged plantar muscles and letting them heal completely.

 

Heel Spurs

Heel spurs are bony protrusions at the base of the heel bone caused due to calcium deposit. Repetitive and long-duration walking, running, or jumping on hard surfaces without wearing protective footwear is one of the most common reasons why you may get them. Very often heel spurs are mistaken for plantar fasciitis. Heel spurs cannot be seen or felt directly. They are only detected through X-Rays. In a majority of cases, they do not cause any pain or discomfort. But, in some cases, they may cause chronic heel pain, especially after walking, jogging, or running. Rest, physical therapy, wearing orthotic insoles, over-the-counter painkillers, anti-inflammatory injections are some of the conventional treatment options for heel spurs.

 

Stone Bruise/ Metatarsalgia

Metatarsalgia is a painful and inflammatory condition of the foot. The pain is mostly felt at the ball of the foot where the metatarsal bones meet the phalanges i.e. the toe bones. It is a deep bruise of the fat pad of the ball of the foot i.e. the area just before the toes, and it feels as if you are walking on stones. You may also feel a burning or stabbing sensation. Therefore, it is also referred as a stone bruise. The pain intensifies when you are on your feet, whether walking, running or standing, but it subsides as soon as you take your feet off the ground. Excessive high-intensity activities, improper footwear, diabetes, gout, injury, blunt trauma, arthritis, and Metatarsalgia fractures are some of the common reasons why you may suffer from metatarsalgia. Treatment options include anti-inflammatory drugs, rest, stretching, and wearing cushiony shoes that help absorb the shock of your routine activities.

 

Heel Bone Fracture

Also known as calcaneus fracture, it is a painful and disabling injury. Heel bone fractures are often a result of traumatic events such as falling from height directly on the feet or during car accidents when your feet have to bear all the weight and shock and the heels get crushed under the weight of the body. During such incidents, the heel bones can widen, shorten, and become deformed. In such cases, surgery is often recommended to reconstruct the heel and restore its mobility. In rare cases, heel bone fractures could also be caused due to ankle sprain i.e. twisting of the ankle and due to excessive, repetitive stress on the heel bones.

 

Bottom of Foot Pain

Very often, we choose footwear that looks good instead of that feels good and that’s why most of us often come back home with battered feet. A recent study has concluded that 9 out of 10 women in the United States wear shoes that are too small for their feet. Implications of ill-fitting shoes extend far beyond just pain and discomfort. Continuous use of ill-fitting shoes can have severe long-term impact on your foot, ankles, knees, hips, and spine. If you are suffering from foot pain, consult a podiatrist to find out if you are wearing the right size and the right type of shoes. Here are some foot problems in which you can experience bottom of foot pain.

 

Morton’s Neuroma

It is a painful condition that involves the thickening of the tissues around one of the nerves that go to the toes. Usually, the pain is felt at the ball of the foot between the third and the fourth toe. Other than sharp pain, you will feel as if you are standing on a pebble or there is a fold in your socks. You will also feel burning sensation or numbness in your toes. In most cases, high-heeled or tight-fitting shoes are responsible for morton’s neuroma. Such shoes put extra pressure on the toes and ball of your foot, thereby injuring the nerves. People with other foot conditions such as flat feet, hammertoe, bunions, high arches, and those involved in high-impact activities such as jogging, running, rock climbing, and snow skiing are also prone to this painful foot condition. Conventional treatment for morton’s neuroma includes switching to wide, low heeled shoes and taking corticosteroid injections and medications.

 

Sesamoiditis

Sesamoids are tiny bones that lie within the tendons. They are not connected to nearby bones. Instead, they are connected to the tendons and act like a pulley, thereby helping the tendons to slide over and improve our mobility. There are many such sesamoids in our body, the biggest one being the kneecap. Our big toe also has one of these tiny bones. Sesamoiditis is a condition in which these tiny bones present in the tendons of the big toe become irritated or fractured. Mild to intense throbbing pain, problem with straightening or bending the big toe, and swelling are some of the symptoms of sesamoiditis. Conservative treatment includes reducing activities that cause pain, ice pack application, resting, taking over-the-counter medications, and wearing low-heeled and well-cushioned shoes.

 

Foot Pain Everywhere

As mentioned above, injury and overuse of foot muscles are responsible for most of the foot problems. In most cases, pain is usually felt at a specific point, such as the heel, the ankle, the toes, the ball, etc. In some foot conditions, the pain is felt throughout the feet or it becomes difficult for the patient to figure out the exact point of the pain. Such conditions are usually due to neuropathy or nerves damage or due to orthopedic trauma. Let’s learn about these conditions in brief.

 

Nerve Damage

The peripheral nervous system of our body is responsible for connecting the nerves from the brain and spinal cord to that of the rest of the body such as hands, legs, mouth, face, etc. These nerves are responsible for sending signals back to the brain. When the nerves of the peripheral system malfunction due to damage or injury, they start sending wrong signals. They might send a pain signal when there is no pain and vice versa. The damage could be due to illness such as diabetes, obesity, injury, infection, or inherited disorder. Nerve damage is also known as peripheral neuropathy. Tingling sensation, sharp stabbing pain, numbness, feeling of weakness or heaviness in feet and arms, etc. are some of the symptoms of peripheral neuropathy. Managing the underlying condition and making healthy lifestyle changes is often recommended for people suffering from nerve damage.

 

Orthopedic Trauma

 

Orthopedic trauma is a broad term that describes a severe injury to the musculoskeletal system, which includes fractures and minor fractures. Such injuries are often caused due to accidents, falls, ankle twisting, blows to a specific part of the body, etc. Persons suffering from osteoporosis and those who have weak bones are more prone to orthopedic trauma. Key symptoms include swelling, tenderness, inability to move the affected part without pain, bone sticking out at an abnormal angle, inability to put any weight, etc. Orthopedic surgery is required to treat the fractured bone and make sure the injured part regains its original strength and function.

We hope this blog helps you identify the reason behind your foot pain and seek some conservative treatment until you have consulted a doctor or podiatrist. As mentioned above, please treat this only as an educational article and not as a substitute of doctor’s advice. If pain persists for more than 2-3 days, seek medical attention.

 

References and citations:

  • America’s Aching Feet. National Pain Report. 2018. Available at: http://nationalpainreport.com/americas-aching-feet-8823864.html.
  • Tarsal Coalition – OrthoInfo – AAOS. Orthoinfoaaosorg. 2018. Available at: https://orthoinfo.aaos.org/en/diseases–conditions/tarsal-coalition/.
  • Arthritis Statistics and Facts. Arthritisorg. 2018. Available at: https://www.arthritis.org/about-arthritis/understanding-arthritis/arthritis-statistics-facts.php.
  • Foot Facts – Foot.com. Footcom. 2018. Available at: https://www.foot.com/foot-facts/.
AAOM Editor

Academic Association of Medicine is the go to resource for all health related issues. We are an independent body that seeks to offer general information on various health topics and unbiased reviews on health products.

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